Provider Demographics
NPI:1033291992
Name:SAVANY, FADELL N (MD)
Entity Type:Individual
Prefix:
First Name:FADELL
Middle Name:N
Last Name:SAVANY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 952
Mailing Address - Street 2:
Mailing Address - City:GARDENDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35071-0952
Mailing Address - Country:US
Mailing Address - Phone:205-608-1233
Mailing Address - Fax:205-608-1833
Practice Address - Street 1:934 GRUBBS AVE
Practice Address - Street 2:
Practice Address - City:GARDENDALE
Practice Address - State:AL
Practice Address - Zip Code:35071-2637
Practice Address - Country:US
Practice Address - Phone:205-608-1233
Practice Address - Fax:205-608-1833
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL17781174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000044516Medicaid
ALF93530Medicare UPIN